PMID- 37802261
OWN - NLM
STAT- MEDLINE
DCOM- 20240226
LR  - 20240226
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 43
IP  - 3
DP  - 2024 Mar
TI  - HLA sensitization is associated with an increased risk of primary graft 
      dysfunction after heart transplantation.
PG  - 387-393
LID - S1053-2498(23)02030-2 [pii]
LID - 10.1016/j.healun.2023.09.017 [doi]
AB  - Primary graft dysfunction (PGD) is a leading cause of early morbidity and 
      mortality following heart transplantation (HT). We sought to determine the 
      association between pretransplant human leukocyte antigen (HLA) sensitization, as 
      measured using the calculated panel reactive antibody (cPRA) value, and the risk 
      of PGD. METHODS: Consecutive adult HT recipients (n = 596) from 1/2015 to 12/2019 
      at 2 US centers were included. Severity of PGD was based on the 2014 
      International Society for Heart and Lung Transplantation consensus statement. For 
      each recipient, unacceptable HLA antigens were obtained and locus-specific cPRA 
      (cPRA-LS) and pre-HT donor-specific antibodies (DSA) were assessed. RESULTS: 
      Univariable logistic modeling showed that peak cPRA-LS for all loci and HLA-A was 
      associated with increased severity of PGD as an ordinal variable (all loci: OR 
      1.78, 95% CI: 1.01-1.14, p = 0.025, HLA-A: OR 1.14, 95% CI: 1.03-1.26, 
      p = 0.011). Multivariable analysis showed peak cPRA-LS for HLA-A, recipient 
      beta-blocker use, total ischemic time, donor age, prior cardiac surgery, and 
      United Network for Organ Sharing status 1 or 2 were associated with increased 
      severity of PGD. The presence of DSA to HLA-B was associated with trend toward 
      increased risk of mild-to-moderate PGD (OR 2.56, 95% CI: 0.99-6.63, p = 0.053), 
      but DSA to other HLA loci was not associated with PGD. CONCLUSIONS: Sensitization 
      for all HLA loci, and specifically HLA-A, is associated with an increased 
      severity of PGD. These factors should be included in pre-HT risk 
      stratification to minimize the risk of PGD.
CI  - Copyright (c) 2023 International Society for the Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Han, Jiho
AU  - Han J
AD  - Section of Cardiology, Department of Medicine, University of Chicago Medical 
      Center, Chicago, Illinois.
FAU - Rushakoff, Josh
AU  - Rushakoff J
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Moayedi, Yasbanoo
AU  - Moayedi Y
AD  - Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada.
FAU - Henricksen, Erik
AU  - Henricksen E
AD  - Department of Transplant, Stanford Health Care, Stanford, California.
FAU - Lee, Roy
AU  - Lee R
AD  - Department of Transplant, Stanford Health Care, Stanford, California.
FAU - Luikart, Helen
AU  - Luikart H
AD  - Division of Cardiovascular Medicine, Department of Medicine, Stanford University, 
      Stanford, California.
FAU - Shalakhti, Omar
AU  - Shalakhti O
AD  - Division of Cardiovascular Medicine, Department of Medicine, Stanford University, 
      Stanford, California.
FAU - Gragert, Loren
AU  - Gragert L
AD  - Department of Pathology, Tulane University School of Medicine, New Orleans, 
      Louisiana.
FAU - Benck, Lillian
AU  - Benck L
AD  - Division of Cardiology, NorthShore University Health System, Chicago, Illinois.
FAU - Malinoski, Darren
AU  - Malinoski D
AD  - Critical Care and Acute Care Surgery, Oregon Health Sciences University, 
      Portland, Oregon.
FAU - Kobashigawa, Jon
AU  - Kobashigawa J
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Teuteberg, Jeffrey
AU  - Teuteberg J
AD  - Division of Cardiovascular Medicine, Department of Medicine, Stanford University, 
      Stanford, California.
FAU - Khush, Kiran K
AU  - Khush KK
AD  - Division of Cardiovascular Medicine, Department of Medicine, Stanford University, 
      Stanford, California.
FAU - Patel, Jignesh
AU  - Patel J
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Kransdorf, Evan
AU  - Kransdorf E
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California. 
      Electronic address: evan.kransdorf@cshs.org.
LA  - eng
PT  - Journal Article
DEP - 20231005
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (HLA Antigens)
RN  - 0 (Antibodies)
RN  - 0 (HLA-A Antigens)
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Primary Graft Dysfunction/epidemiology/etiology
MH  - *Heart Transplantation/adverse effects
MH  - HLA Antigens
MH  - Tissue Donors
MH  - Antibodies
MH  - HLA-A Antigens
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Calculated panel reactive antibodies
OT  - Heart transplantation
OT  - Human leukocyte antigen
OT  - Primary graft dysfunction
OT  - Sensitization
EDAT- 2023/10/07 00:41
MHDA- 2024/02/26 06:42
CRDT- 2023/10/06 19:26
PHST- 2022/12/01 00:00 [received]
PHST- 2023/08/30 00:00 [revised]
PHST- 2023/09/24 00:00 [accepted]
PHST- 2024/02/26 06:42 [medline]
PHST- 2023/10/07 00:41 [pubmed]
PHST- 2023/10/06 19:26 [entrez]
AID - S1053-2498(23)02030-2 [pii]
AID - 10.1016/j.healun.2023.09.017 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2024 Mar;43(3):387-393. doi: 
      10.1016/j.healun.2023.09.017. Epub 2023 Oct 5.